First case report of Schistosoma japonicum in Nepal

Abstract

<jats:p> <jats:bold>Background.</jats:bold> Schistosomiasis, globally, is significant public as well as veterinary health problem as it is associated with a wide range of clinical conditions in humans and animals. Schistosomiasis is mostly caused by the following species of genus <jats:italic>Schistosoma</jats:italic>: <jats:italic>Schistosoma japonicum</jats:italic>, <jats:italic>Schistosoma haematobium, Schistosoma mekongi, Schistosoma intercalatum Schistosoma guineensis, Schistosoma malayensis</jats:italic> and <jats:italic>Schistosoma mansoni. S. japonicum</jats:italic> might be considered as the most pathogenic among these species as the clinical disease caused by this parasite ranges from mild diarrhea, nausea, Katayama fever, portal hypertension, splenomegaly and ascites to liver cirrhosis and fibrosis. <jats:italic>S. japonicum</jats:italic> has been commonly encountered in China, the Philippines and Indonesia. According to WHO, at least 220.8 million people required preventive treatment for schistosomiasis in 2017 but only 102.3 million people were reported to have been treated. To our knowledge, there are no cases reported from Nepal. Hence, this is the first reported case of <jats:italic>S. japonicum</jats:italic> in Nepal.</jats:p> <jats:p> <jats:bold>Case presentation.</jats:bold> A case of acute schistosomiasis due to <jats:italic>S. japonicum</jats:italic> was identified in CIWEC Hospital and Travel Medicine Center, Kathmandu, Nepal. The patient arrived with gastrointestinal symptoms without any pre-existing chronic illness with no evidence of travel outside of Spain since last August, but had travelled to many other countries 2 years ago. Timely diagnosis by stool routine and microscopic examination and formal-ether concentration technique led to successful treatment of the disease.</jats:p> <jats:p> <jats:bold>Conclusion.</jats:bold> As the parasite has not been reported to date in Nepal, many people are unaware of its mode of infection and pathogenesis. Many laboratory workers are heedless with the egg of the parasite due to which this parasite might be misdiagnosed or undiagnosed. This case report might help laboratory workers to be sentient about the parasite and further diagnosis in future.</jats:p>

Schistosomiasis in non-endemic areas: Italian consensus recommendations for screening, diagnosis and management by the Italian Society of Tropical Medicine and Global Health (SIMET), endorsed by the Committee for the Study of Parasitology of the Italian Association of Clinical Microbiologists (CoSP-AMCLI), the Italian Society of Parasitology (SoIPa), the Italian Society of Gastroenterology and Digestive Endoscopy (SIGE), the Italian Society of Gynaecology and Obstetrics (SIGO), the Italian Society of Colpo

“… *Different transmission status within the country Interruption of transmission to be confirmed (screening in asymptomatic subjects usually not recommended): Algeria, Antigua and Barbuda, Djibouti, Japan, Jordan, Guadeloupe, India, Iran, Lebanon, Malaysia, Morocco, Martinique, Mauritius, Montserrat, Puerto Rico, Dominican Republic, Thailand, Tunisia, Turkey. Additional countries and territories not previously considered endemic for schistosomiasis where transmission has been reported recently (screening in asymptomatic subjects usually not recommended): Myanmar, Nepal and Pakistan in Asia, Corsica (France) and Almeria (South-East Spain) in Mediterranean Europe [ 9 , 10 , 49 , 57 , 58 ] Source: IAMAT, WHO. …”

“…Additional countries and territories not previously considered endemic for schistosomiasis where transmission has been reported recently (screening in asymptomatic subjects usually not recommended): Myanmar, Nepal and Pakistan in Asia, Corsica (France) and Almeria (South-East Spain) in Mediterranean Europe [ 9 , 10 , 49 , 57 , 58 ]…”

“…Besides the epidemiological criterion, when the clinical picture is suggestive, it is advisable to investigate schistosomiasis among the differential diagnoses because, as reported by literature, cases have been described in areas previously considered as non-endemic (e.g., Myanmar, Nepal, Pakistan, Almeria in South-East Spain, Corsica in France) [ 9 , 10 , 49 , 57 , 58 ].…”

Schistosomiasis in Europe

“…Nevertheless, the actual number of endemic countries could be higher. For example, cases of schistosomiasis have been reported recently in Nepal [3,4], in Myanmar [5], as well as in Europe (please see further below).…”

Biochanin A in murine Schistosoma mansoni infection: effects on inflammation, oxidative stress and fibrosis

“…Schistosomiasis affects over 200 million people with more than 250,000 deaths per year. In 2017, 220.8 million needed schistosomiasis prophylaxes, with only 102.8 million receiving treatment (Bajracharya et al , 2020). Most infections occur in rural and low-income areas of sub-Saharan Africa (Adenowo et al , 2015).…”